11.3 Consequential Chemicals: Antidepressant Risks during Pregnancy

Renegade Psych

Dr. Urato has been talking about the risks of SSRIs (Prozac, Zoloft, Lexapro, Paxil, etc.) during pregnancy for almost as long as he was talking about the risks of Makena, nearly two decades. He reveals to us the data behind the FACT that there are risks to the developing fetus of maternal SSRI use during pregnancy, starting with the common sense evidence, followed by information obtained from human research, animal randomized controlled trials, and finally and most recently, MRI and functionalMRI findings in children of mothers on antidepressants. The point of this series (or our jobs as physicians) is not to pill shame anybody or over-exaggerate the risks of SSRIs in pregnancy, it is to provide our patients with the most up-to-date and SCIENTIFIC evidence to collaborate WITH them and HELP them make the best and most informed decisions for them. I reveal to Adam some of the pharmaceutical industry's disdain for lithium, one of the oldest, cheapest, and most effectives medication in all of psychiatry, as well as some of the questionable recommendations for its use during pregnancy, especially in light of the risks of the most commonly used class, SSRIs. Lithium is by no means safe during pregnancy, especially at high doses, however, its risks may be somewhat sensationalized, and I hope to have Adam back on in the future to discuss the potential lower risk in unipolar and bipolar depressed pregnant patients.

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